经皮冠状动脉腔内介入与冠状动脉搭桥手术治疗冠心病

目的:观察冠心病(CHD)完全再血管化(CR)与非完全再血管化(ICR)的远期随访结果。方法:回顾性分析作者在美国犹他大学LDS医院研修时参与的4948例CHD患者接受冠状动脉搭桥术(CABG)和经皮冠状动脉腔内介入治疗(PCI)CR与ICR的远期随访结果。结果:多支冠状动脉病变PCI-ICR与PCI-CR相比,PCI-ICR组患者发生心肌梗死(MI)、再行CABG、重复PCI、再发心绞痛以及死亡的比率均稍高于PCI-CR组,但差异均无显著性意义。单支多处病变PCI-ICR与PCI-CR相比,1年再发心绞痛及再行CAGB较高(P<0.01),但MI及死亡率差异无显著性意义(P>0.05)。结论:CHD患者PCI-ICR的策略是可行的。

Long-term outcome of patients with incomplete vs complete revascularization undergoing PCI and CABG

Objective: The long-term outcome of complete versus incomplete revascularization was observed. Methods:The data of long-term outcome of complete versus incomplete revascularization obtained from LDS hospital, Utah university, USA were retrospectively analyzed in a total of 4 948 cases with CHD. Results:In multivessel group, the incidences of myocardial infarction(MI), coronary artery bypass surgery(CABG) . repeat percutaneous coronary interventivon (PCI) , recurrent angina and death in patients undergoing incomplete revascularization were slight higher than those in patients undergoing complete revascularization in 1 year follow-up, but the differences were not significant ( P>0. 05). In single-vessel multilesion group, the incidences of recurrent angina and CABG in patients with incomplete revascularization were higher ( P <0. 01) than those in patients with complete revascularization but not higher for MI and death. Conclusion: The PCI strategy of incomplete revascularization in patients with coronary heart disease is feasible.